Yesterday, the U.S. Department of Health and Human Services (“HHS”) published a rule finalizing a number of policies related to the implementation of the Patient Protection and Affordable Care Act (“Program Integrity Rule”). In the Preamble of the Program Integrity Rule, HHS indicates that it plans to propose future rulemaking to change how the $63 per covered life reinsurance fee will be collected, and that certain self-insured, self-administered plans will be exempted from the fee for 2015 and 2016 benefit years.
Employers that self-insure will still need to pay the transitional reinsurance fee for 2014. A blog that discusses transitional reinsurance fees can be found here. For 2015 and 2016, it is not clear at this time how broadly HHS intends to apply the exemption.
With regard to the collection of the reinsurance fees, HHS states that to alleviate the upfront burden of the reinsurance contributions, HHS intends to adopt a new payment schedule and collect reinsurance contributions in two installments. First, the reinsurance contributions for reinsurance payments and administrative expenses would be collected at the beginning of the calendar year following the applicable benefit year. Second, the contributions for payments to the U.S. Treasury would be collected at the end of the calendar year following the applicable benefit year.
The Program Integrity Rule can be found here.